2026-2027 Teen Leadership Institute Application Form

Please complete the application form below in its entirety.  Incomplete application forms will not be given consideration for participation.

Application forms are due no later than Friday, September 18 at 3:00 p.m.

Program Requirements: 

  • Attend a Pitt County high school (Public, Private, & Homeschool)
  • Currently enrolled as a junior (11th grade)
  • Carry a minimum unweighted GPA 3.0
  • Demonstrate outstanding qualities as existing or potential leaders and possess the desire to affect change in their community
  • Attach a minimum of one (1) signed letter of recommendation from a teacher, coach, employer, etc.

  1. General Information (Applicant):

  4. Select School:
  6. Select Gender:
  8. Select Ethnicity:
  10. Select T-Shirt Size:
  12. Address:
  14. Preferred Contact Phone Number:
  15. *Please expect a phone call if accepted after October 8th*
  17. Email (enter preferred email address):
  19. Food Restrictions/Allergies:
  21. Parent(s) / Guardian(s) Name:
  23. Emergency Contact:
  25. Emergency Contact Number:

  27. Applicant Questions:

  28. Please share why you are interested in applying for the Teen Leadership Institute and what do you hope to gain if selected to participate?
  30. What does Leadership mean to you?

  32. Personal/Community Involvement:

  33. In order of importance to you, please list up to three (3) school related activities, organizations, or athletics in which you have participated or are currently participating. (Please include organization, year, and leadership position, if applicable)
  37. In order of importance to you, please list up to (3) three non-school related activities or organizations in which you have participated or are currently participating. (Volunteer, religious, social, community)
  41. List any honors/awards you have received from participating in any of the activities listed in the questions above.

  43. Future Career Interests:

  44. Please list three (3) professional careers you are most interested in pursuing.

  48. Teen Leadership Institute Essay Questions

  49. Q1: Please describe a time when you made a significant impact on a team, project, or situation. What was your role, what actions did you take and what did you learn from the experience?
  51. Q2: Please describe the qualities or characteristics you admire most in your role model. How have these traits influenced you or shaped your own goals?

  53. Please upload the following document before submitting your form.

  55. What are this students greatest strengths? In what ways could this student continue to grow as a leader? Why do you recommend this student for the TLI?

Payment